BI-RADS

Question 1

Category 0

Answer 1

Incomplete, needs additional imaging

Question 2

Category 1

Answer 2

Negative; routine mammo screening

Question 3

Category 2

Answer 3

Benign; routine mammo screening

Question 4

Category 3

Answer 4

Probably benign; short interval 6 month f/u or continued surveillance

Question 5

Category 4

Answer 5

Suspicious; tissue diagnosis

Question 6

Category 4A

Answer 6

Low suspicion for malignancy

Question 7

Cat. 4B

Answer 7

Moderate suspicion for malignancy

Question 8

Cat 4C

Answer 8

High suspicion for malignancy

Question 9

Category 5

Answer 9

Highly suggestive of malignancy; tissue diagnosis

Question 10

Category 6

Answer 10

Known biopsy proven malignancy; surgical excision when clinically appropriate

Question 11

How will a mass be described?

Answer 11

According to its shape, density, and margin

Question 12

Different shapes of a mass

Answer 12

1) round (benign shape)
2) oval (benign shape)
3) irregular (malignant shape)

Question 13

Different margins of a mass

Answer 13

1) circumscribed (well rounded)- benign
2) indistinct (not like any other)- malignant
3) speculated (fingers growing off)- malignant
4) obscured (see only part of it)- benign
5) micro-lobulated (bumpy)- benign or malignant

Question 14

Diffused calcification

Answer 14

Random throughout breast

Question 15

Regional calcification

Answer 15

Occupying a large portion of the breast

Question 16

Grouped calcification

Answer 16

Few calcifications occupying a small portion of the breast

Question 17

Linear calcification

Answer 17

Arranged in a line

Question 18

Segmental calcification

Answer 18

Deposits in a duct or ducts and their branches

Question 19

Calcifications typically benign

Answer 19

-round
-dystrophic (calcs in scar tissue)
-skin calcs
-vascular cals
-rimed or halo
-milk of calc
-rod like
-popcorn shape

Question 20

Amorphous or indistinct calcs

Answer 20

Small and hazy, specific shape cannot be determined. 20% biopsied are malignant

Question 21

Coarse heterogeneous calcs

Answer 21

Irregular calcs clearly visible, (bright anf chunky) between 0.5 mm and 1 mm. About 15% biopsied are malignant

Question 22

Fine pleomorphic calcs

Answer 22

Have individual, separate, and distinct shapes; usually <0.5 mm about 25-40% chance of being malignant

Question 23

Fine linear branching calcs

Answer 23

Thin, linear irregular calcs, may be discontinuous, occasionally branching forms can be seen <0.5 mm

Question 24

Cyst

Answer 24

Mass with sac like pocket that contains fluid, air, or other substances. Often circumscribed and see through

Question 25

Simple cyst

Answer 25

-Fluid filled, smooth thin walls. -always benign

Question 26

Complex cysts

Answer 26

-Contain something besides fluid -f/u or biopsy

Question 27

Galactocele

Answer 27

-milk filled cyst -occurs more after breastfeeding has stopped; milk is retained and becomes stagnant within breast ducts -always benign, does not increase bc risk

Question 28

Fibroadenoma

Answer 28

-benign tumors composed of stromal and epithelial elements (multiple might indicate increased risk of bc) -common in younger women

Question 29

Lipoma

Answer 29

-pocket of fat encapsulated by thin fibrous capsule (common) -slow growing tumors more common in post menopausal women

Question 30

Hamartoma (fibroadenolipoma)

Answer 30

-benign proliferation of fibrous, glandular, and fatty tissue -surrounded by thin capsule of connective tissue

Question 31

Ductal ectasia

Answer 31

-lactiferous duct widens, duct walls thicken and duct is filled with fluid -milk duct may be blocked by thick, sticky substance -can cause green or black discharge -in peri or post menopausal women -does not increase bc

Question 32

Hematoma

Answer 32

-blood filled swelling caused by trauma to the breast (common after biopsy) -not cancerous -may leave behind scar tissue

Question 33

Breast abscess and inflammation

Answer 33

-occur as complication of mastitis (bacterial infection that causes breast to become red and inflamed) -usually in women breaststroke

Question 34

Fat necrosis (oil cyst)

Answer 34

-damaged or dead tissue -can happen following needle biopsy, breast surgery -feels like a firm lump, usually painless -does not increase risk of bc -usually goes away itself

Question 35

Lymph nodes

Answer 35

-small clumps of immune cells that act as filters for lymphatic system -lymphatic system runs throughout entire body and carries fluid and cells -axillary lymph nodes are first place bc is likely to spread

Question 36

Radial scar

Answer 36

-Area of hardening of breast tissue that can occur as breast ages -stellate configuration (speculated); can mimic malignancy -Self-limiting breast tumor that is a result of a new disorganized cell growth.

Question 37

Papilloma (benign and high risk)

Answer 37

-tumor growing in the ducts inside the nipple with finger like fronds -may cause nipple discharge or bleeding -surg. to remove

Question 38

Lobular Carcinoma (LCIS)

Answer 38

-not considered to be cancer -having LCIS does increase risk of bc -does not cause a lump and can’t be seen on mammo; found when biopsy is done for another problem in the breast